title: Liver fat accumulation after islet transplantation and graft survival.
abstract: Our objective is to evaluate if there is an association between liver fat accumulation after islet transplantation (ITx) and graft survival. A cohort study was conducted in 34 subjects with type 1 diabetes postallogeneic ITx. Liver fat content was evaluated by magnetic resonance imaging (MRI) (change in liver signal intensity on in-phase and opposed-phase images). Kaplan-Meier curves and Cox regression analysis were performed with islet dysfunction duration as the dependent variable and fat liver content as an independent one. Values of p < 0.05 were significant (SSPS(®)18.0 and MedCalc(®)12.5). Patients' mean age was 40 ± 8 years (diabetes duration: 31 ± 12 years; male: 41%). Islet survival did not differ in patients without (51 months, 95% CI 40-62 months) or with steatosis (48 months, 95% CI 38-58 months; p = 0.55) during islet dysfunction period. Nevertheless, survival curves appear to separate late in the follow-up, and after 40 months steatosis was associated with shorter graft survival (p log rank = 0.049). This association remained (RR 23.5, 95% CI 1.1-516.0; p = 0.045) after adjustments for possible confounding factors. In this sample of subjects with type 1 diabetes submitted to ITx, steatosis was not associated with islet failure in the whole cohort. However, in subjects with functional islets after 40 months, a shorter graft survival was observed in those with steatosis during the islet dysfunction period, even after adjustments to variables known to be associated with islet failure.
authors.affiliation: Diabetes Research Institute, Miami, FL, USA.
authors.forename: Cristiane Bauermann
authors.initials: CB
authors.lastname: Leitão
authors.forename: Eduardo Moraes Leao
authors.initials: EM
authors.lastname: Peixoto
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Westphalen
authors.forename: Leonor G
authors.initials: LG
authors.lastname: Mireles-Zavala
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Lauriola
authors.forename: Karina
authors.initials: K
authors.lastname: Bernetti
authors.forename: Andrea
authors.initials: A
authors.lastname: Corrales
authors.forename: Camillo
authors.initials: C
authors.lastname: Ricordi
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Alejandro
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism* / Q000628:therapy*; D005234:Fatty Liver / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects* / Q000379:methods*; D008099:Liver / Q000378:metabolism* / Q000473:pathology; D008297:Male